What do you view as the greatest opportunity presented by the proposed MSSP changes? What is the greatest challenge?

I think the greatest opportunity with the new changes may be the risk adjustment; getting a positive upward adjustment really would have helped us in our first contract period. I think that is a positive for this. Also, some of the regional adjustments are also a positive for many ACOs or most ACOs.

On the negative side, making groups move to risk sooner is going to harm the program and that fewer people are going to join or you will have more dropout and the evidence has shown that when ACOs stay in longer and we have more ACOs, that the trust fund is going to save more money. I think that’s really where we need to focus on the program. Not how much savings are achieved based on the benchmark, but how much of the true savings are we achieving for the trust fund?